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 Researchers compared data on more than 2 million U.S. women to a
group of about 1,650 of their peers in Germany, where almost
three-fourths of first-time mothers started pregnancy at a healthy
weight and only 27 percent exceeded weight gain recommendations.
“The differences in overweight rates pre-pregnancy and in weight
gain are surprising,” lead study author Dr. Joachim Dudenhausen, an
obstetrics researcher at Charite University Medicine in Berlin, said
by email. “We must follow these data for some years to find an
explanation.”
While the cause of the discrepancies is unclear, the health effects
of excessive weight gain during pregnancy, or starting out
overweight, are well known, he said.
Short-term problems can include overweight babies, births
complicated by infants’ shoulders getting stuck on the way out, and
a greater likelihood of a surgical delivery by cesarean section, he
said. Over the long haul, babies can have a greater risk of
diabetes, hypertension and metabolic syndrome, which increases the
odds of heart attacks and strokes in adulthood.
Women who are underweight at the start of pregnancy should gain 28
to 40 pounds, while women who are normal weight are advised to gain
25 to 35 pounds, according to the U.S. Institute of Medicine. For
overweight women, a 15- to 25-pound gain is recommended and obese
women should gain just 11 to 20 pounds.
To see how often women were below, within or above recommended
weight ranges for pregnancy, Dudenhausen and colleagues assessed
weight gains for the German and American pregnancies based on their
pre-pregnancy body mass index (BMI), a measure of weight relative to
height.
An adult who is 5 feet 9 inches tall and weighs from 125 to 168
pounds would have a BMI of 18.5 to 24.9 and be considered a healthy
weight, according to the U.S. Centers for Disease Control and
Prevention. An obese adult at that height would have a BMI of 30 or
more and weigh at least 203 pounds.
Pre-pregnancy, 72 percent of the German women were at a healthy
weight, compared with just 47 percent for the Americans, the study
found. Four percent of the women in the U.S. and in Germany were
underweight.
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In Germany, 39 percent of women gained too little during pregnancy,
almost twice the rate in the U.S. And, overall, less than one in
three American or German women stayed within the recommended weight
gains during pregnancy.
The findings confirm that obesity is an epidemic, and that doctors
need to counsel women on proper nutrition and exercise well before
pregnancy to make it more likely that they start out at a healthy
weight, the researchers write in American Journal of Obstetrics and
Gynecology.
“Over the last two to three decades, there has been a significant
increase in obesity among pregnant women in the U.S., and the
proportion of overweight women in Germany is significantly less but
also increasing,” said Dr. Amos Grunebaum, director of obstetrics at
NYP/Weill Cornell Medical Center in New York.
Obesity increases the risk of infertility and miscarriages,
Grunebaum, a co-author on the study, said by email.
“Obese women may have to make significant changes in their eating
habits in order to improve chances of getting pregnant and having
healthy babies,” he said.
SOURCE: http://bit.ly/1GZsbV2 American Journal of Obstetrics and
Gynecology, online June 9, 2015.
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